Multiple Nodule Removal by Disc Excision and Segmental Resection in Multifocal Colorectal Endometriosis
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This paper describes a surgical technique involving disc excision and segmental resection for removing multiple nodules of colorectal endometriosis.
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Abstract
Study objectiveTo report postoperative outcomes after dual digestive resection for deep endometriosis infiltrating the rectum and the colon.DesignA retrospective study using data prospectively recorded in the CIRENDO database (Canadian Task Force classification II-2).SettingA university tertiary referral center.PatientsTwenty-one patients managed for multiple colorectal deep endometriosis infiltrating nodules.InterventionsConcomitant disc excision and segmental resection of both the rectum and sigmoid colon.Measurements and main resultsThe assessment of postoperative outcomes was performed. Rectal nodules were managed by disc excision and segmental resection in 20 patients and 1 patient, respectively. Sigmoid colon nodules were removed by short segmental resection and disc excision in 15 and 6 patients, respectively. The rectal nodule diameter was between 1 and 3 cm and over 3 cm in 33% and 67% of patients, respectively. Associated vaginal infiltration requiring vaginal excision was recorded in 76.2% of patients. The mean diameter of the rectal disc removed averaged 4.6 cm, and the mean height of the rectal suture was 5.8 cm. The length of the sigmoid colon specimen and the height of the anastomosis were 7.3 cm and 18.5 cm, respectively. The mean operative time was 290 minutes, and the mean postoperative follow-up averaged 30 months. Clavien-Dindo 3 complications occurred in 28% of patients, including 4 with rectal fistulae (19%). The pregnancy rate was 67% among patients with pregnancy intention.ConclusionOur data suggest that combining disc excision and segmental resection to remove multiple deep endometriosis nodules infiltrating the rectum and the sigmoid colon can preserve the healthy bowel located between 2 consecutive nodules. However, the rate of postoperative complications is high, particularly in patients with large low rectal nodules.
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- Cumulative Pregnancy Rates Among Patients With Bowel Endometriosis According to Therapeutic Approach. A Systematic Review and Meta-Analysis 2025
- Laparoscopic Double Discoid Colorectal Resection for the Treatment of Two Distinct Deep Endometriotic Nodules 2023
- Colorectal endometriosis: Diagnosis, surgical strategies and post-operative complications 2022
- Endometriosis in Reproductive Years: Surgical Management of Colorectal Endometriosis 2022
- Disk Excision Using End-to-End Anastomosis Circular Stapler for Deep Endometriosis of the Rectum: A 492-Patient Continuous Prospective Series 2022
- Deep Endometriosis and Infertility: What Is the Impact of Surgery? 2022
- SURGICAL TECHNIQUES FOR THE TREATMENT OF RECTAL ENDOMETRIOSIS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS AND OBSERVATIONAL STUDIES 2021
- Surgical Management by Disk Excision or Rectal Resection of Low Rectal Endometriosis and Risk of Low Anterior Resection Syndrome: A Retrospective Comparative Study 2021
- Risk of Rectovaginal Fistula in Women with Excision of Deep Endometriosis Requiring Concomitant Vaginal and Rectal Sutures, with or without Preventive Stoma: A Before-and-after Comparative Study 2021
- Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection 2021
- SURGICAL TECHNIQUES FOR THE TREATMENT OF RECTAL ENDOMETRIOSIS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS AND OBSERVATIONAL STUDIES 2021
- Live surgery of colorectal endometriosis broadcasted from a surgeon’s routine operating theater is not associated with higher complications rate 2021
- Le taux global de complications postopératoires n’est pas un marqueur fiable de l’expérience d’un chirurgien : une série rétrospective de 1060 interventions pour endométriose colorectale 2020
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- Risk of bowel fistula following surgical management of deep endometriosis of the rectosigmoid: a series of 1102 cases 2020
- Could stoma reduce the risk of rectovaginal fistula in women with excision of deep endometriosis requiring concomitant vaginal and rectal sutures? A 363-patient comparative study 2020
- Interposition of a biological mesh does not decrease the risk of rectovaginal fistula after excision of large rectovaginal endometriotic nodules: a pilot study of 209 patients 2020
- Low anterior resection syndrome following different surgical approaches for low rectal endometriosis: A retrospective multicenter study 2020
- Imaging of gastrointestinal endometriosis: what the radiologist should know 2020
- Double Disk Excision of Large Deep Endometriosis Nodules Infiltrating the Low and Mid Rectum: A Pilot Study of 20 Cases 2020
- Postoperative imaging findings after laparoscopic surgery for deeply infiltrating endometriosis 2020
- Risk of Postoperative Stenosis after Segmental Resection versus Disk Excision for Deep Endometriosis Infiltrating the Rectosigmoid: A Retrospective Study 2020
- Posterior rectal pouch after large full-thickness disc excision of deep endometriosis infiltrating the low/mid rectum and relationship with digestive functional outcome 2020
- Postoperative Bowel Symptoms Improve over Time after Rectosigmoidectomy for Endometriosis 2019
- Post-operative complications and recurrence rate after treatment of bowel endometriosis: Comparison of three techniques 2019
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